Bridging Research, Policy, and Public Debate on Assisted Dying

Posted on by Suzanne Ost

Hands of a younger lady holding a grandmother's hands. © Adobe192946781

My long-standing research interest in Assisted Dying (1996-2026)

It seems like a lifetime ago that I completed my PhD on assisted dying (AD), back in 2000. At that time, AD was permitted in only a handful of jurisdictions worldwide. Fast forward twenty-six years, and it’s now lawful in over 30 jurisdictions.

Throughout this time, AD’s status as a major bioethical controversy has generated a large and growing body of research across fields such as health care law and ethics, health (in)equalities, medical practice, palliative and end-of-life care, and social justice. Although my own research has addressed numerous issues in health care law and ethics and child sexual abuse and exploitation over the years, AD has remained a continuing focus. For example, in 2010, I suggested how models of AD could be less medicalised, including provision outside of health care. In 2013, I critiqued the different treatment of doctors and layperson-assistors in AD cases, and the criminal law’s avoidance of hard questions in co-authored book with Professor Margaret Brazier that analysed the intersection of the criminal law and bioethics as part of an AHRC-funded project. In another book written with Hazel Biggs on exploitation in health care in 2021, I explored how vulnerabilities can be exploited in AD, and suggested a new offence of undue influence/coercion to address this.

But research doesn’t end with publication, especially in a field as contested as AD. I didn’t want engagement with the public and policymakers to be an optional add‑on, because my research is on an issue with such significant real‑world consequences.

Public and Policy Engagement following legal developments on AD

Notwithstanding numerous human rights-based challenges to the legal prohibition on assisted suicide, the publication of the prosecutorial policy on assisted suicide in England and Wales, and the introduction of several private members' bills at Westminster and in Scotland, there were only limited legal developments within UK jurisdictions and the Crown Dependencies. Public engagement was generally limited to opinion polls that were generally supportive of legal reform. Then, in the early 2020s, the tide started to turn.

1. Jersey’s Citizens’ Jury on Assisted Dying and its Assisted Dying Law (2021-2026)

In 2021, Jersey held its Citizens’ Jury on Assisted Dying. Over 10 jury sessions, the 23 jury members heard from expert witnesses from around the world, stakeholders, advocates representing all sides of the debate, and those with lived experience. Their task was to answer the question: should assisted dying be permitted in Jersey and, if so, under what circumstances? I was appointed to support the design and delivery of the sessions and act as an Expert Adviser to the jury, alongside my former PhD student, Dr Alexandra Mullock (University of Manchester). At the end of the Jury process, the majority of Jury members (78%) recommended that assisted dying should be permitted in Jersey. Acting on these recommendations, the States Assembly then became the first parliament in the British Isles to make an 'in principle' decision to allow assisted dying. A period of careful public and stakeholder engagement over several years and a review of law reform proposals by an AD Review Panel followed, culminating in the publication of a draft AD law in September 2025.

It was an honour to be appointed to advise the AD Review Panel on their considered, thorough scrutiny of this draft law, publishing a co-authored report for the Panel with my Lancaster colleague Professor Nancy Preston and Dr Alexandra Mullock. Following the Panel’s final report and lodged amendments to significantly enhance the robustness of the proposed legislation (several of which were accepted), Jersey’s AD law was approved in February 2026.

I was especially pleased that a number of accepted amendments to the draft law reflected our recommendations to, for example:

  • better differentiate between the offences on coercion (in terms of penalties);
  • ensure the inclusion of and consultation with representatives for Islanders with disabilities in the implementation stage and post-implementation review of the operation of the law;
  • ensure greater clarity on a person’ decision to waive future capacity in the event that they lost capacity before the final step in the AD process

Jersey’s AD law now awaits Royal Assent, which will be followed by an 18-month period of implementation.

2. The Nuffield Council on Bioethics’ Citizens’ Jury on Assisted Dying and the Terminally Ill Adults (End of Life) Bill in England (2024-2026)

As the path to legalisation progressed in Jersey, the Nuffield Council on Bioethics (NBOC) held a Citizens’ Jury on AD in England in 2024. I was invited to be one of the two critical friends to the jury, offering advice and guidance to the 30 jury members as they deliberated on the question of whether the law should be changed to permit AD. The jury’s final report, published in 2025, was a testimony to their commitment to carefully examine the evidence that they heard. The majority of the jury decided that ‘the law in England should be changed to permit assisted dying.’

I have since been appointed as a Council Member of the NCOB, and strongly support the Council’s commitment to public engagement, such as that which occurred through its citizens’ jury, as a significant element of its vision to embed ethics at the centre of policy decision-making that is informed by ‘evidence about what matters to people concerning the issues at stake’.

The NCOB’s Citizens’ Jury on AD was extremely timely because, at a similar time to the publication of the jury’s final report, Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill (TIAB) was introduced in the House of Commons. In continuing research with Nancy Preston, we have suggested alternative models of AD and focused on implementation challenges that happen after AD is legalised. This led to our offering advice and expertise to Westminster parliamentarians on the TIAB, including adding further safeguards and the importance of implementation issues. We produced policy briefs, meeting with MPs individually and at an event for parliamentarians that we held in Portcullis House in 21st November 2024, where we spoke to Kim Leadbeater MP. Our recommendation for prospective oversight through a multidisciplinary panel to review requests was part of our evidence to the Public Committee on the Bill, and was picked up by the Committee when the inclusion of a High Court judge to review cases came under pressure.

Whilst the TIAB has fallen in the House of Lords, there are plans to attempt to bring it back in the next parliamentary session. The implementation challenges that Nancy Preston, Alexandra Mullock and I have identified remain.

Moving Research into the Public and Policy Sphere: Why Engagement and Impact Matter

Elsewhere, I have argued that AD ‘exemplifies a bioethical issue that resonates powerfully with the public, and this should make public engagement a vital part of any process that might result in legal reform.’ Throughout my public engagement work and work in an advisory capacity to parliamentarians in Jersey and England, it has been a privilege to discuss AD with members of the public and parliamentarians, to go beyond research, to strive to produce real-world impact by tackling a complex societal challenge and influencing policy that may, ultimately, lead to significant legal reform.

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